Smith T P, Koci T, Mehringer C M, Tsai F Y, Fraser K W, Dowd C F, Higashida R T, Halbach V V, Hieshima G B
Department of Radiology, University of California San Francisco.
J Vasc Interv Radiol. 1993 Sep-Oct;4(5):681-5. doi: 10.1016/s1051-0443(93)71948-x.
The authors retrospectively reviewed their 4-year clinical experience to determine the role of transarterial embolization in the treatment of symptomatic vertebral hemangioma.
Eight patients (age range, 12-56 years) underwent a total of 10 embolization procedures; one patient underwent three procedures. The lesions were located between T-5 and L-5, and all patients presented with pain and symptoms referable to the lower extremities.
Embolization was technically successful in all patients, and no complications were encountered. Six of eight patients underwent surgery within 48 hours of embolization; four of the six showed significant clinical improvement immediately after surgery and on follow-up (average, 34 months). Two patients did not improve postoperatively. Two patients initially underwent embolization as the sole therapy. The first refused surgery and did not improve clinically; the second underwent two embolization procedures without clinical improvement and eventually underwent a third followed by surgery, which resulted in clinical improvement. All patients were hemodynamically stable during surgery, and blood loss was not problematic in any patient.
Overall, surgery was an effective treatment for symptomatic vertebral hemangioma and the authors conclude that transarterial embolization of vertebral hemangioma is a safe and efficacious adjunctive procedure to such surgery. However, embolization was not as promising as a sole therapeutic modality in this small group of patients.
作者回顾性分析了他们4年的临床经验，以确定经动脉栓塞在有症状椎体血管瘤治疗中的作用。
8例患者（年龄范围12 - 56岁）共接受了10次栓塞手术；1例患者接受了3次手术。病变位于T - 5至L - 5之间，所有患者均表现为疼痛及下肢相关症状。
所有患者的栓塞技术均成功，且未出现并发症。8例患者中有6例在栓塞后48小时内接受了手术；其中4例在术后及随访（平均34个月）时临床症状显著改善。2例患者术后未改善。2例患者最初仅接受栓塞治疗。第1例拒绝手术，临床症状未改善；第2例接受了2次栓塞手术但临床症状未改善，最终接受了第3次栓塞手术，随后进行手术，临床症状得以改善。所有患者在手术期间血流动力学稳定，且所有患者均未出现失血问题。
总体而言，手术是有症状椎体血管瘤的有效治疗方法，作者得出结论，椎体血管瘤的经动脉栓塞是此类手术安全有效的辅助手段。然而，在这一小部分患者中，栓塞作为单一治疗方式的前景并不乐观。
